Patient: I am 33 years old, since the birth of my child in 2006 my body has not been able to recover, I am easily fatigued, my blood work is often not within the reference range, the percentage of lymphocytes has been in the range of 50-60%, the white blood cells have been below 4. Recently I had the following blood tests, please take a look: Ferritin 5.3(11-306.8), Immunoglobulin IgG 1720(723-1685), serum iron 3.5(9-30), immunoglobulin IgA 269(69-382), iron saturation 4.0(20-50), immunoglobulin IgM 177(63-277), total iron binding capacity 87.5(54-77), folic acid 11.73(4.2-19.9), vitamin B12 380( 180-914), peripheral, homogeneous, granular, nucleolar, and adnexal types were all negative. I have taken 6 vitamin iron extended-release tablets, but my stomach was upset and my appetite would be bad, so I didn’t take them after that (I have superficial gastritis). 1. Is my fatigue now related to my anemia? 2. Is my iron deficiency severe? Is my anemia moderate or severe? Liu Jiajun, Department of Hematology, The Third Affiliated Hospital of Sun Yat-sen University: Hello! Thank you for your consultation! From the information you provided, the blood routine is microcytic hypochromic anemia, and your serum iron and ferritin are significantly decreased, thus, it is a typical iron deficiency anemia. Your recent decrease in hemoglobin compared to the original is a mild form of anemia, so there is no need to worry too much. The treatment of iron deficiency anemia is mainly to first find the cause (yours may be chronic superficial gastritis), followed by iron supplementation. Generally speaking, the first thing is to take iron orally (after meals). Iron is mainly absorbed in the duodenum, and some people may have different degrees of gastrointestinal reactions after taking it orally. You have already taken it orally, and you may have a gastrointestinal reaction and stop it. Therefore, I recommend that you go to the hematology department of your local hospital and use injectable iron therapy, such as iron dextran and iron sucrose. Fatigue is a common symptom of anemia, but from your two routine blood tests, you also have leukopenia, which is a common cause of weakness and fatigue. Therefore, I suggest you take some oral leukocyte-raising drugs, such as Lixisen, shark’s glycol, vitamin B4, and compound aconite syrup. There is nothing wrong with your other tests. In addition, you can eat more iron-containing foods, such as lean meat, mushrooms, pig’s blood or duck’s blood. Do not drink tea while taking the medicine. I wish you a speedy recovery!